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General NPI Number Information
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NPI Number | 1629253943
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Entity Type | Organization
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Legal Business Name | LEVELLAND EYE AND VISION PC
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Dates
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Enumeration Date | 01/05/2008
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Last Update Date | 07/21/2015
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Provider Practice Location Address
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Address Line | 608 AUSTIN ST
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City | LEVELLAND
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State | TX
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Zip | 79336-4616
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Country | US
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Telephone | 806-894-6330
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Fax | 806-894-2443
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Provider Business Mailing Address
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Address Line | 608 AUSTIN ST
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City | LEVELLAND
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State | TX
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Zip | 79336-4616
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Country | US
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Telephone | 806-894-6330
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Fax | 806-894-2443
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GEORGE W. PAYNE JR.
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Credential | O.D.
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Telephone | 806-894-6330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1969TG
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License Number State | TX
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